The ongoing COVID-19 pandemic has brought unprecedented demands on the nation’s health care system, and it also has changed the way people receive care. For patients, the need to continue to receive care remotely from their trusted health care provider is important for healthy outcomes.
During the pandemic, hospitals and health systems have used critical flexibilities that the Centers for Medicare & Medicaid Services (CMS) established under waiver authority enacted by Congress to allow telehealth services to reach even more patients.
The American Hospital Association is urging Congress to make these changes permanent:
Elimination of the 1834(m) geographic and originating site restrictions, so patients can continue to receive telehealth services in their homes, residential facilities and other locations.
Without this change, much of the progress that has been made over the past months to significantly increase patient access to care will disappear, since the status quo limits telehealth to rural areas of the country and requires patients to be at certain types of facilities to receive care.
Coverage and reimbursement for audio-only services, allowing hospitals and health systems to maintain access to care for numerous patients who do not have access to broadband or video conferencing technology.
Elimination of state licensure laws requiring a person practicing medicine to obtain a full and unrestricted license authorizing that person to engage in the practice of medicine within that state or territory.
Support for adequate reimbursement for the substantial upfront and ongoing costs of establishing and maintaining a virtual infrastructure, including secure platforms, licenses, IT support, scheduling, patient education and clinician training.
Without adequate reimbursement of these costs, providers may be forced to decrease their telehealth offerings. Adequate reimbursement for virtual services also is key to ensuring providers have the means to invest in HIPAA-compliant technologies and to deliver these services with high quality of care.
Expansion of types of healthcare facilities that can offer telehealth care—specifically to allow Rural Health Clinics and Federally Qualified Health Centers to serve as distant sites, so these facilities can use the providers at their own sites to offer patient care.
Expansion of types of providers that can deliver and bill for telehealth services to include, among others, physical therapists, occupational therapists and speech-language pathologists.
The current public health emergency (PHE) is set to expire on April 21, 2021. The continued adoption and expansion of telehealth is largely dependent on how Congress decides to handle these obstacles moving forward.
Proposed Legislation
In late February, bipartisan groups of lawmakers in both the House and the Senate introduced the Telehealth Modernization Act, a bill that would permanently remove Medicare's geographic and originating site restrictions which require a patient to live in a rural area and be physically in a doctor's office or clinic to use telehealth services. With a bipartisan consensus building around removing these restrictions, the bill avoids more controversial telehealth policy issues such as payment parity and interstate licensing.
There are several other telehealth legislative efforts also underway and the March 2 House hearing played an important part in gathering information and starting to develop a consensus on certain key issues. With strong bipartisan support for telehealth, it is possible that a bill could pass into law in a matter of months. On the flip side, Congress can also move very slowly. But even from a pessimistic standpoint, it is likely that some form of telehealth reform legislation will be passed into law before the end of the PHE.
The future of telehealth will be here shortly…are you confident that Congress will pass the proposed legislation?
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